The prostate gland is situated just below the bladder and surrounds the urethra. Prostatitis is swelling and inflammation of the prostate gland, that results in pressure on the urethra leading to painful urination, difficulty urinating, pain in the groin, pelvic area or genitals and sometimes flu-like symptoms.
Prostatitis affects men of all ages but tends to be more common in men 50 or younger. The condition has a number of causes. Sometimes the cause isn't identified. Depending on the cause, prostatitis can come on gradually or suddenly. It might improve quickly, either on its own or with treatment. Some types of prostatitis last for months or keep recurring (chronic prostatitis).
Prostatitis signs and symptoms depend on the cause. They can include:
Pain or burning sensation when urinating (dysuria)
Difficulty urinating, such as dribbling or hesitant urination
Frequent urination, particularly at night (nocturia)
Urgent need to urinate
Cloudy urine or Blood in the urine
Pain in the abdomen, groin, lower back or in the area between the scrotum and rectum (perineum)
Pain or discomfort of the penis or testicles
Flu-like signs and symptoms (with bacterial prostatitis)
Acute bacterial prostatitis is often caused by common strains of bacteria. The infection can start when bacteria in urine leak into the prostate. Antibiotics are used to treat the infection. If they don't eliminate the bacteria, prostatitis might recur or be difficult to treat (chronic bacterial prostatitis).
Nerve damage in the lower urinary tract, which can be caused by surgery or trauma to the area, might contribute to prostatitis not caused by a bacterial infection. In many cases of prostatitis, the cause isn't identified.
Risk factors for prostatitis include:
Being a young or middle-aged
Past history of prostatitis
Having an infection in the bladder or the tube that transports semen and urine to the penis (urethra)
Having pelvic trauma, such as an injury from bicycling or horseback riding
Using a tube inserted into the urethra to drain the bladder (urinary catheter)
Having had a prostate biopsy
Complications of prostatitis can include:
Bacterial infection of the blood (bacteremia)
Inflammation of the epididymis - coiled tube attached to the back of the testicles
Prostatic abscess – pus filled cavity in the prostate
Semen abnormalities and infertility, can occur with chronic prostatitis
There's no direct evidence that prostatitis can lead to prostate cancer.
In case of pelvic pain, difficult or painful urination, or painful ejaculation, see the doctor. If left untreated, some types of prostatitis can cause worsening of infection or other health problems.
Initial diagnostic tests might include:
Urine tests to look for signs of infection in your urine (urinalysis).
Blood tests for signs of infection and other prostate problems.
Post-prostatic massage to test the secretions.
Imaging tests may include ultrasound of prostate or CT scan
Based on the symptoms and test results, there may be following types of prostatitis:
Acute Bacterial Prostatitis. Often caused by common strains of bacteria, this type of prostatitis generally starts suddenly and causes flu-like signs and symptoms, such as fever, chills, nausea and vomiting.
Chronic Bacterial Prostatitis. When antibiotics don't eliminate the bacteria causing prostatitis, can develop recurring or difficult-to-treat infections. Between bouts of chronic bacterial prostatitis, there might be no symptoms or only minor ones.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome. This type of prostatitis — the most common —isn’t caused by bacteria. Often an exact cause can't be identified. For some men, symptoms stay about the same over time. For others, the symptoms go through cycles of being more and less severe.
Asymptomatic Inflammatory Prostatitis. This type of prostatitis doesn't cause symptoms and is usually found only by chance when undergoing tests for other conditions. It doesn't require treatment.
Prostatitis treatments depend on the underlying cause. They can include:
Antibiotics. This is the most commonly prescribed treatment for prostatitis and is given empirically or based on culture and sensitivity results.
In case of severe symptoms, there may be a need for intravenous (IV) antibiotics. Oral antibiotics are normally prescribed for four to six weeks but might need longer treatment for chronic or recurring prostatitis.
Alpha Blockers. These medications help relax the bladder neck and the muscle fibers where your prostate joins your bladder. This treatment might ease symptoms, such as painful urination.
Anti-inflammatory Agents. Nonsteroidal anti-inflammatory drugs (NSAIDs) might make you more comfortable.
Alternative therapies that show some promise for reducing symptoms of prostatitis include:
Biofeedback. A biofeedback specialist uses signals from monitoring equipment to teach you to control certain body functions and responses, including relaxing your muscles.
Acupuncture. This involves inserting very thin needles through your skin to various depths at certain points on your body.
Herbal remedies and supplements. There's no evidence that herbs and supplements improve prostatitis, although many men take them. Some herbal treatments for prostatitis include rye grass (cernilton), a chemical found in green tea, onions and other plants (quercetin) and extract of the saw palmetto plant.
The following might ease some symptoms of prostatitis:
Soak in a warm bath (sitz bath) or use a heating pad.
Limit or avoid alcohol, caffeine, and spicy or acidic foods, which can irritate the bladder.
Avoid activities such as prolonged sitting or bicycling that can irritate prostate.
Drink plenty of caffeine-free beverages. This will cause more urination and help flush bacteria from the bladder.